What Impact Do Medicolegal Complaints Have on Canadian Plastic Surgeons?

Background: Being named in a medicolegal complaint can be a lengthy process filled with uncertainties. Its current impact on Canadian plastic surgeons is unknown. We aim to review the impact of medicolegal complaints and provide advice for surgeons on how to prevent, minimize, and navigate through the medicolegal process. Method: An anonymous survey was sent to registered Royal College of Physicians and Surgeons of Canada certified plastic surgeon members. The survey collected data on surgeon demographics (clinical status, gender, practice type, volume), medicolegal complaint history and outcome, impact on practice, and insights into the process. Surgeons with an inactive practice and invalid contact information were excluded. Results: Out of 456 invited plastic surgeons, 100 responses were included, 73% were male, with an even distribution of practice types and years in practice. Most were Canadian Medical Protective Association (CMPA) members. A significant portion (62%) had been named in a medicolegal action, primarily related to treatment complications (42%) and poor outcomes/disease progression (34%). Factors associated with complaints were greater years in practice (P<.01), and a higher annual volume of operating room cases (P=.02). The duration of the medicolegal process varied, with the majority taking 1-2 years. Respondents predominantly agreed that CMPA provided adequate legal defence (83%, 53/64). However, most surgeons felt the process had a significantly negative impact on their mental health (75%, 48/64). After being involved in a complaint, many surgeons modified their practice pattern by increasing documentation/consent process (45%, 29/64), avoiding certain procedures (22%, 14/64), and avoiding care of high-risk patients (19%, 12/64). Conclusion: Despite legal resolution in favour of the physicians, the results of this survey indicate the medicolegal complaint process has a significant impact on plastic surgeons' practices, time, and mental health. Understanding the medicolegal process and outcome is crucial for risk mitigation.